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The influence of femoral tunnel length on graft rupture after anterior cruciate ligament reconstruction.
Guglielmetti, Luiz Gabriel Betoni; Shimba, Leandro Girardi; do Santos, Leonardo Cantarelli; Severino, Fabrício Roberto; Severino, Nilson Roberto; de Moraes Barros Fucs, Patrícia Maria; de Paula Leite Cury, Ricardo.
Affiliation
  • Guglielmetti LGB; Knee Group of the Department of Orthopedics and Traumatology of Santa Casa de Misericórdia of São Paulo, Santa Casa School of Medical Sciences, São Paulo-Fernandinho Simonsen Pavilion, São Paulo, Brazil. luizgbg@terra.com.br.
  • Shimba LG; , Pascal, 1292, Ap91, Campo Belo, São Paulo, São Paulo, 04616-004, Brazil. luizgbg@terra.com.br.
  • do Santos LC; Knee Group of the Department of Orthopedics and Traumatology of Santa Casa de Misericórdia of São Paulo, Santa Casa School of Medical Sciences, São Paulo-Fernandinho Simonsen Pavilion, São Paulo, Brazil.
  • Severino FR; Knee Group of the Department of Orthopedics and Traumatology of Santa Casa de Misericórdia of São Paulo, Santa Casa School of Medical Sciences, São Paulo-Fernandinho Simonsen Pavilion, São Paulo, Brazil.
  • Severino NR; Knee Group of the Department of Orthopedics and Traumatology of Santa Casa de Misericórdia of São Paulo, Santa Casa School of Medical Sciences, São Paulo-Fernandinho Simonsen Pavilion, São Paulo, Brazil.
  • de Moraes Barros Fucs PM; Knee Group of the Department of Orthopedics and Traumatology of Santa Casa de Misericórdia of São Paulo, Santa Casa School of Medical Sciences, São Paulo-Fernandinho Simonsen Pavilion, São Paulo, Brazil.
  • de Paula Leite Cury R; Knee Group of the Department of Orthopedics and Traumatology of Santa Casa de Misericórdia of São Paulo, Santa Casa School of Medical Sciences, São Paulo-Fernandinho Simonsen Pavilion, São Paulo, Brazil.
J Orthop Traumatol ; 18(3): 243-250, 2017 Sep.
Article in En | MEDLINE | ID: mdl-28213787
BACKGROUND: For ACL reconstruction, the minimum length of the femoral tunnel and the flexor tendon graft length needed within the tunnel for proper integration have not been defined. The aim of this study was to assess whether a short tunnel is a risk factor for poor prognosis and re-rupture by comparing the outcomes of patients with short femoral tunnels to those of patients with longer tunnels. MATERIALS AND METHODS: A retrospective observational study of 80 patients who underwent ACL reconstruction using flexor tendons via the medial transportal or transtibial technique was performed. Patients were categorized according to the amount of graft within the tunnel: ≤1.5 versus >1.5 cm; ≤2 versus >2 cm; ≤2.5 versus >2.5 cm; and ≤1.5 versus >2.5 cm. Patients were evaluated 2 years after surgery by performing a physical examination (Lachman, pivot shift and anterior drawer tests), using a KT1000 arthrometer, calculating objective and subjective International Knee Documentation Committee scores, conducting the Lysholm score, and recording re-ruptures. RESULTS: Of the 80 operated patients, nine were lost to follow-up. Comparative assessment of the patients with different amounts of graft within the tunnel indicated no significant differences in the evaluated outcomes, except for positive Lachman test results, which were more frequent in patients with tunnels with ≤2 cm of graft than in those with tunnels with >2 cm of graft. CONCLUSION: The amount of graft within the femoral tunnel does not appear to be a risk factor for clinical instability of the knee or re-rupture of the graft. LEVEL OF EVIDENCE: case series, level IV. LEVEL OF EVIDENCE: Case series, level IV.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Femur / Anterior Cruciate Ligament Reconstruction Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Female / Humans / Male Language: En Journal: J Orthop Traumatol Journal subject: ORTOPEDIA / TRAUMATOLOGIA Year: 2017 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Femur / Anterior Cruciate Ligament Reconstruction Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Female / Humans / Male Language: En Journal: J Orthop Traumatol Journal subject: ORTOPEDIA / TRAUMATOLOGIA Year: 2017 Document type: Article Affiliation country: Country of publication: